Effects of unilateral upper limb training in two distinct prognostic groups early after stroke: The EXPLICIT-stroke randomized clinical trial

Gert Kwakkel, Caroline Winters, Erwin E H Van Wegen, Rinske H M Nijland, Annette A A Van Kuijk, Anne Visser-Meily, Jurriaan De Groot, Erwin De Vlugt, J. Hans Arendzen, Alexander C H Geurts, Carel G M Meskers

Research output: Contribution to journalArticleScientificpeer-review

69 Citations (Scopus)

Abstract

Background and Objective. Favorable prognosis of the upper limb depends on preservation or return of voluntary finger extension (FE) early after stroke. The present study aimed to determine the effects of modified constraint-induced movement therapy (mCIMT) and electromyography-triggered neuromuscular stimulation (EMG-NMS) on upper limb capacity early poststroke. Methods. A total of 159 ischemic stroke patients were included: 58 patients with a favorable prognosis (>10° of FE) were randomly allocated to 3 weeks of mCIMT or usual care only; 101 patients with an unfavorable prognosis were allocated to 3-week EMG-NMS or usual care only. Both interventions started within 14 days poststroke, lasted up until 5 weeks, focused at preservation or return of FE. Results. Upper limb capacity was measured with the Action Research Arm Test (ARAT), assessed weekly within the first 5 weeks poststroke and at postassessments at 8, 12, and 26 weeks. Clinically relevant differences in ARAT in favor of mCIMT were found after 5, 8, and 12 weeks poststroke (respectively, 6, 7, and 7 points; P

Original languageEnglish
Pages (from-to)804-816
JournalNeurorehabilitation and Neural Repair
Volume30
Issue number9
DOIs
Publication statusPublished - 2016

Keywords

  • constraint-induced movement therapy (CIMT)
  • electromyography-triggered neuromuscular stimulation (EMG-NMS)
  • randomized controlled trial (RCT)
  • stroke
  • upper limb

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